NPIMap

Organization Active NPI

Neshoba County General Hospital

  • Certified Registered Nurse Anesthetist
  • Philadelphia, MS
National Provider Identifier
1114057247
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11227 Issued in MS
Legal business name
NESHOBA COUNTY GENERAL HOSPITAL
Practice address
1001 Holland Ave
Philadelphia, MS 39350-2161
Phone
(601) 663-1200
Fax
(601) 663-1379
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Scott McNair
Title
Cfo
Phone
(601) 663-1233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 11227 MS Primary

Addresses

Primary practice location

1001 Holland Ave
Philadelphia, MS 39350-2161

Mailing address

PO Box 648
Philadelphia, MS 39350-0648
Phone (601) 663-1200

Other identifiers 2

IdentifierTypeStateIssuer
000019181AOtherMSBLUE CROSS BLUE SHIELD CRNA
09013715MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000618 MS Part B Supplier - Clinic/Group Practice 6204738289 Receives reassigned benefits from 53 practitioners
4 other NPIs on this enrollment
Practice locations: Philadelphia, MS

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ms Neurodiagnostic Lab16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Neshoba County General HospitalPhiladelphia, MS, CCN 25U043 Hospital Operational/Managerial Control (100%) May 1, 2009
Neshoba County General Hospital Psych UnitPhiladelphia, MS, CCN 25S043 Hospital Operational/Managerial Control May 1, 2009
Neshoba County General HospitalPhiladelphia, MS, CCN 25Z340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General HospitalPhiladelphia, MS, CCN 251340 Hospital Operational/Managerial Control Jan 1, 2025
Neshoba County General Hospital-Nursing HomePhiladelphia, MS, CCN 255137 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Oct 22, 2009
Oct 22, 2009
Oct 22, 2009
Neshoba Medical AssociatesPhiladelphia, MS, CCN 258559 Rural health clinic Other (100%) Apr 1, 2012

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 55

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501027200000",
    "number": "1114057247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393500648",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-663-1200",
            "fax_number": "601-663-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2017-07-26",
        "status": "A",
        "authorized_official_last_name": "MCNAIR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-663-1233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "11227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD CRNA",
            "identifier": "000019181A",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013715",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.